title: Circulatory death determination in uncontrolled organ donors: a panel viewpoint.
abstract: One barrier for implementing programs of uncontrolled organ donation after the circulatory determination of death is the lack of consensus on the precise moment of death. Our panel was convened to study this question after we performed a similar analysis on the moment of death in controlled organ donation after the circulatory determination of death. We concluded that death could be determined by showing the permanent or irreversible cessation of circulation and respiration. Circulatory irreversibility may be presumed when optimal cardiopulmonary resuscitation efforts have failed to restore circulation and at least a 7-minute period has elapsed thereafter during which autoresuscitation to restored circulation could occur. We advise against the use of postmortem organ support technologies that reestablish circulation of warm oxygenated blood because of their risk of retroactively invalidating the required conditions on which death was declared.
authors.affiliation: Department of Neurology, Dartmouth-Hitchcock Medical Center, Lebanon, NH. Electronic address: bernat@dartmouth.edu.
authors.forename: James L
authors.initials: JL
authors.lastname: Bernat
authors.affiliation: Department of Neurology, Rush University Medical Center, Chicago, IL.
authors.forename: Thomas P
authors.initials: TP
authors.lastname: Bleck
authors.affiliation: Pittsburgh Critical Care Associates, Pennsylvania State Hershey Medical Center, Hershey, PA.
authors.forename: Sandralee A
authors.initials: SA
authors.lastname: Blosser
authors.affiliation: Department of Pediatric Critical Care, University of Utah Medical Center, Salt Lake City, UT.
authors.forename: Susan L
authors.initials: SL
authors.lastname: Bratton
authors.affiliation: Gould School of Law and Keck School of Medicine, the University of Southern California, Los Angeles, CA.
authors.forename: Alexander M
authors.initials: AM
authors.lastname: Capron
authors.affiliation: LifeQuest Organ Recovery Services, Gainesville, FL.
authors.forename: Danielle
authors.initials: D
authors.lastname: Cornell
authors.affiliation: Department of Critical Care, Harlem Hospital, New York, NY.
authors.forename: Michael A
authors.initials: MA
authors.lastname: DeVita
authors.affiliation: Department of Surgical Intensive Care, Christiana Health Care System, Newark, DE.
authors.forename: Gerard J
authors.initials: GJ
authors.lastname: Fulda
authors.affiliation: New England Organ Bank, Boston, MA.
authors.forename: Alexandra K
authors.initials: AK
authors.lastname: Glazier
authors.affiliation: Departments of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA.
authors.forename: Cynthia J
authors.initials: CJ
authors.lastname: Gries
authors.affiliation: Department of Pediatric Critical Care, Loma Linda University Children's Hospital, Loma Linda, CA.
authors.forename: Mudit
authors.initials: M
authors.lastname: Mathur
authors.affiliation: Department of Pediatric Critical Care, Wake Forest Baptist Health, Winston-Salem, NC.
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Nakagawa
authors.affiliation: Department of Pediatric Critical Care, Montreal Children's Hospital, McGill University, Montreal, Quebec, Canada.
authors.forename: Sam D
authors.initials: SD
authors.lastname: Shemie
mesh_terms: D026683:Advisory Committees; D001775:Blood Circulation; D001926:Brain Death; D016887:Cardiopulmonary Resuscitation; D002985:Clinical Protocols; D003643:Death; D006801:Humans; D014019:Tissue Donors; D009927:Tissue and Organ Procurement / Q000379:methods* / Q000592:standards; D014481:United States